State health officials were in town Tuesday to hear arguments for and against Morton Hospital's plan to close its 13-bed pediatric unit.

The Department of Public Health held the hearing, which took place at the Taunton Public Library, as part of a state review of the hospital's proposal.

Marc Larocque

State health officials were in town Tuesday to hear arguments for and against Morton Hospital's plan to close its 13-bed pediatric unit.

The Department of Public Health held the hearing, which took place at the Taunton Public Library, as part of a state review of the hospital's proposal.

Throughout most of the hearing, a packed crowd of local pediatricians, nurses from the hospital, officials from local public health organizations and everyday citizens from the Taunton area rallied against the plan to shut down the unit and expressed concern that the decision to close it was motivated by profits. The opponents to the closure cited various reasons that the unit should remain open, including the need for access to acute pediatric care for low income families that don’t have means of transportation to facilities in Boston or Providence, and the quality of the experienced nurses who work in the Level II pediatric unit, among many other points.

Top ranking hospital officials and a spokesperson for Morton’s for-profit corporate owner Steward Healthcare, which bought the Taunton medical facility in 2011 with plans of investment and commitment to the community, spoke in favor of closing the pediatric unit. Morton Hospital President Kimberly Bassett said that the pediatric unit’s low volume of patients made it impossible to retain or recruit physicians, and that children deserve a higher level of care that comes with a pediatric unit staff that has skills honed from a larger amount of admissions.

“Following this hearing, the Department will make a determination as to whether the service to be discontinued is necessary to preserving access and health status in the hospital service area,” said Sherman Lhones, assistant director of the Division of Health Care Quality at Department of Public Health (DPH). “The department will consider evidence presented at this hearing for current utilization of this service, the capacity for alternate sites to provide the service, and other relevant information available to the department.”

Lhones, who oversaw the meeting, said that DPH will make its determination within 15 days. If the department finds that the service to be discontinued is necessary to preserving access and health status, the department will require hospital to submit a plan assuring access to the service within 15 calendar days of its finding. The DPH will respond to the hospital in writing with approval or written comments, to which the hospital must respond, Lhones said.

“DPH will work closely with the hospital and with other area providers to ensure that any plan includes the appropriate continuity of care for patients in the area,” said Anne Roach, a DPH spokesperson.

During the meeting, Bassett and other hospital officials said that they would be offering space to another provider to staff the pediatric unit with a $1 rent. Bassett also said the hospital would be adding a small, dedicated pediatric observation unit with four beds, located in the emergency department and staffed by emergency department workers, for short hospital stays.

State Sen. Marc Pacheco, D-Taunton, who supported Steward’s takeover of Morton because the company’s promises to invest in the hospital, spoke out against the closure of the unit. Pacheco said he was troubled that Steward bought the company, commiting to keeping Morton as a community hospital, before soon closing the pediatric unit that has been open since 1957.

Pacheco said recent advertisements put out by Steward — which said it would be harmful to keep the pediatric unit open – were “insulting.” After the hearing, Pacheco quoted Steward Health Care CEO Ralph de la Torre, from comments made in the announcement of Morton’s purchase two years ago, stating the “we believe that patients should not have to travel to get their care, rather it is our goal to bring world class care to patients where they live.”

Steward spokesperson Christopher Murphy said “the grandstanding by the Senator on such an important issue was very disappointing, particularly when you consider that he has no clinical knowledge or information on the subject matter.”

Pacheco responded saying that the “grandstanding” comment was a “low blow,” and that it doesn’t speak highly of Steward.

“What I was doing was my job,” said Pacheco, who is currently vice chair of the state legislature’s public health committee. “I still hope that things can work out. Unfortunately those types of comments continue to undermine the credibility of Steward.”

Pacheco, and several nurses who spoke during the hearing, challenged the pediatric unit census numbers put forth by Steward, owned by a New York-based financial private equity firm called Cerberus, by instead citing daily assignment sheet figures collected by nurses who work in the unit. While Steward says that it has an average of less than one admission each day — or 285 in a year — opponents to the pediatric unit’s closure said that daily assignment sheets at the unit show otherwise, with four to eight patients being cared for each day with common conditions such as dehydration and breathing problems.

Mary Wilkinson, an acute care pediatric nurse for the past eight years at Morton, said that, “our busy months will show you that our daily census has been as many as 10 patients in one day.” Wilkinson said the assignment sheets at the pediatric unit “tell a very different story than what you have been led to believe.”

Murphy said that the problem is Tufts Medical Center cancelled its contract to continue providing acute pediatric care at Morton because of low volume. No other hospitals will come to provide the care, and no local pediatricians that Steward has approached will do it, Murphy said.

“Finances had nothing to do with this and still have nothing to do with it,” Murphy said. “We’ve explored every option. Once Tufts is gone, (the pediatric unit) has no coverage. … This is about quality and safety.”

Dr. Harvey Kowaloff, vice president for medical affairs at Morton, agreed with Bassett, saying that “repetition and experience” is needed for the pediatric unit staff to provide top quality care.

“You wouldn’t want surgery from a surgeon who performs two times a week,” Kowaloff said. Responding to those who referenced the pediatric units history of 50 years in the community, Kowaloff said he understands concern by staff and members of the community but “time has past and medical practices continue to evolve.”

Taunton Mayor Thomas Hoye, Jr., defended the pediatric unit at Morton, saying that the decision to close the unit “caught him off guard” and questioned whether Steward foresees any other changes like this in the future. City Council President John McCaul and City Councilor Sherry Costa Hanlon also spoke to the importance of the pediatric unit, providing personal experiences with the quality of care there and talking about the backlash they’ve heard from constituents who are against the closure.

Many retired nurses, current emergency department nurses and several nurses now on the pediatric unit spoke out, saying that the service was important to local families and that the company was not doing enough to promote the hospitalist position at the pediatric unit. Several questions Steward’s logic about their skills stagnating with low volumes, explaining that several nurses have been recognized as top quality professionals in the state, and that all the nurses go through continual education and certification processes to maintain and expand their skills.

“I am asking Steward to reconsider and to keep our children in their family,” said Kathy daGraca, a nurse at the pediatric unit for 30 years. “I pray that no child is adversely affected by this proposed closure. … I am fearful that removing this service from our community could result in some families hesitating to seek care for their sick children as they will not have to endure lengthy ER visits with potential transfers to hospitals miles away.”

Pacheco said the matter would ultimately come before DPH Acting Commissioner Cheryl Bartlett and the state Attorney General Martha Coakley’s Office.

“This is a unique situation, this is not the typical nonprofit hospital closing a unit,” he said.

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